Preloading before spinal anaesthesia for caesarian section. A comparison between colloid and crystalloid preload

ABSTRACT

To compare the preloading effect of 500 ml hydroxyethyl starch [HES] 6% with 1000 ml of Ringer's lactate to prevent hypotension in spinal anaesthesia for elective cesarean section. Randomized clinical trial. PAF hospital Islamabad, from November 2005 to March 2006. The trial was conducted in two groups of healthy women, scheduled to have elective cesarean section with no fetal compromise. The first group received HES 6% 500 ml [HES group] [n=25] and the second group was infused with 1000 ml Ringer's lactate [RL group] [n=25], in 15 minutes before administering spinal anaesthesia. The incidence of hypotension [systolic B.P < 90 mm Hg or <80% of baseline], and incidence of nausea and/ or vomiting were recorded. Neonatal outcome was aasessed by apgar scoring at 1, 5 and 10 min. The incidence of hypotension was lower in HES group than RL group. Hypotension occurred in 9 out of 25 women [36%] who received HES 6%, while 15 out of 25 women [60%] of RL group developed hypotension. The incidence of nausea and or vomiting was also lower in HES group [24% vs. 40%]. Neonatal outcome was good and similar in both groups preloading preganant ladies undergoing elective cesarean section, with 500 ml HES 6%, 15 min before induction of spinal anaesthesia decreases the incidence of hypotension more than preloading with 1000 ml Ringer's lactate